Psychological development and intervention strategies with children with Attention Deficit Hyperactivity Disorder (ADHD)

Author(s)

Camila Tarif Ferreira Folquitto

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Instituto de Psicologia (IP/SBD)
• Defense date: 2013-12-13

Examining board members

Maria Thereza Costa Coelho de Souza; Rogerio Lerner; Lino de Macedo; Cristiana Castanho de Almeida Rocca; Claudia Broetto Rossetti

• Advisor: Maria Thereza Costa Coelho de Souza

Abstract

ADHD is a complex disorder, whose understanding is often controversial. ADHD symptoms, to some degree, are present in children with different ages and backgrounds, reinforcing the need to study this phenomenon from a theoretical perspective that considers the development of children. In a previous study (Folquitto, 2009), it was investigated the development of children diagnosed with ADHD. They were also evaluated according to whether use psycho stimulant medications or not. Comparing subgroups, no significant differences were observed, indicating that the use of these medications has not contributed sufficiently to favour the development of ADHD children. In the present research, we aimed at developing intervention strategies that could enable children to enhance development, constructing new procedures who lead, progressively, to more advanced structures of thinking. The hypothesis of this work was to investigate if it is possible to provide, based on the Piagetian theory, experiences that facilitate the construction of cognitive and affective capacities that would favour the development of these children, as well as to investigate their spontaneous beliefs about time. This is a longitudinal study, performing interventions with games and problem-solving situations that stimulate children to analyse their activities and to acquire meaningful knowledge, favouring the construction of new procedures, awareness of actions and cognitive structuring. Participants were 18 children, aged 7-12 years old. Previously, and after the intervention, participants and their parents were interviewed to assess the development of operational notions, neuropsychological measures of Executive Functions and ADHD symptoms. We used the following instruments: SNAP-IV, WISC-III´s subtests \"Vocabulary\", \"Block Design\", \"Coding\", \"Digit Span\" and \"Symbol Search\", Rey Osterrieth Complex Figure (ROCF), and the Piagetian tasks Conservation of discrete quantities; Change of criteria - dichotomy; the tasks Three mountains, Succession of Events Perceived, The ideia of points and the ideia of continuity, Simultaneity, and The time of the action and the internal duration.Participants were divided into an experimental group, who took part in the intervention (n=13), and a control group (n=5), composed by ADHD children who did not take part in the intervention program. For the intervention group there were statistically significant differences when comparing the assessments before and after the intervention for symptoms, IQ, processing speed and executive functions. Comparing the two periods, there was significant difference in the responses of piagetian tasks as a whole (p=0.011), the Three mountains task (p=0.024) and Simultaneity (p=0.023). The comparison group showed no statistically significant difference in the performance evaluations for the measures analyzed. Regarding spontaneous beliefs about time, the majority of children conceptualized time as linked with action itself, not considering aspects like the succession of movements and sensation of time going by. Results indicate that interventions with games, mediated by professionals, can be useful tools to assist and enhance the development of children with ADHD, decreasing symptoms and improving executive functions. Specially, this results demonstrate that intervention method performed, based on use of games mediated by professionals, was effective in mobilizing self-regulation and awareness processes by participants. Thus, they were able to move forward in its development, building better procedures and affective and cognitive structuring more adapted. Results presented can be interpreted as an indication that long-term interventions, involving problem solving situations, reflections on the actions and awareness are fundamental to enable children with ADHD to have more meaningful learning processes and developing (AU)

• FAPESP's process: 10/17481-3 - Psychological development and intervention strategies in children with Attention Deficit Hyperactivity Disorder (ADHD)
• Grantee: Camila Tarif Ferreira Folquitto
• Support Opportunities: Scholarships in Brazil - Doctorate